Birth Companions: Perspectives on Doulas and Nurse Midwives in ASL and English. A creation of the College of St. Catherine in partnership with SLICES, LLC.


Introducing Jerri Middlebrook

Jerri gives an introduction about her educational and family background. (1:49)

English Summary

Jerri introduces herself as a birth doula, someone who offers support to pregnant women during their pregnancy and delivery. She has a BA and is completing a MA in Communication where her thesis is focused on how doctors communicate with Deaf women giving birth and how communication styles affect the woman through labor and delivery. Jerri’s goal as a doula is to continue to support and empower Deaf women during their pregnancy, labor and delivery.

Jerri explains about her family background and discusses her responses to questions about whether being black or being Deaf is a stronger part of her identity.

 


Why did you become a doula?

Jerri explains what led her to become a doula. (1:57 )

English Summary

Jerri introduces herself as a birth doula, someone who offers support to pregnant women during their pregnancy and delivery. She has a BA and is completing a MA in Communication where her thesis is focused on how doctors communicate with Deaf women giving birth and how communication styles affect the woman through labor and delivery. Jerri’s goal as a doula is to continue to support and empower Deaf women during their pregnancy, labor and delivery.

Jerri explains about her family background and discusses her responses to questions about whether being black or being Deaf is a stronger part of her identity.

 


Who pays for your services?

Jerri explains how she is paid for her services. (0:57)

English Summary

Jerri explains she gets paid from a non-pro?t agency called Family Center Doula Program*. She is part of their programming to reduce infant mortality in St. Paul (MN). She was trained to be available to support Deaf women and state funds funneled through the agency pay for her services. *The actual name of the program is: Family Center Community Doula Program under the auspices of the American Indian Family Center in St. Paul: www.aifc.net.

 


What does a doula do throughout the labor and delivery process?

What does a doula do throughout the labor and delivery process? Jerri gives more speci?cs about what she does in her role before, during, and after the birth.

English Summary

Jerri usually is referred to a mom by someone else. She’ll arrange to meet the mom and explain what a doula does. She’ll answer any questions the mom may have and provide any information the mom may need at that time. She prefers to meet with the mom at least three times before the baby is born so she can understand where the mom is coming from, what she wants and needs from Jerri.

At the second meeting, Jerri will usually talk about comfort measures like how to lessen the pain in back labor or possibly prevent it in the ?rst place. They discuss how to manage pain, medication and its effects and other things.

By the third visit, Jerri likes to go with the woman to a doctor’s appointment. That way she can introduce herself, let the doctor know she’ll be there as a support person for the mom and exchange contact information.

Sometimes the moms will call when they’re not sure what’s happening and if they should go to the hospital or not. Jerri will encourage them to contact their doctor to ask those kinds of questions. When the mom is thinking about going to the hospital, Jerri will offer to wait with them at their house or go and wait with them at the hospital. A couple of times, women have asked her to come to their homes and be with them to talk, provide physical and emotional support and information. She may even cook and freeze food for the family to have for the next few weeks.

Once at the hospital, Jerri waits with the mom through labor and once she starts to deliver, gives her information on how to push effectively. If the mom wants to nurse her baby after birth, Jerri can teach her how to breast feed. She encourages nursing because it’s good for the baby. After that, she’ll stop by the hospital to visit the mom, see if she has any questions and particularly to re?ect with the mom on her birth experience. Jerri’s able to help the mom see what a powerful experience it was and to remind her of what a wonderful and amazing job she did by giving birth. Jerri feels it is her responsibility to empower the mom.

Jerri tends to stop and visit the mom a week or so after she returns home and leaves herself open to the mom for follow-up support for about two months or a little longer, depending on what the mom needs. She still has contact with some moms over a year later. She knows that the moms feel a special bond with her because she’s shared such an amazing experience with them. It’s very powerful to give birth and to have this new person come into your life and profoundly change everything about your life. Because she was a part of that, some moms still feel a strong connection with Jerri. Jerri now even babysits some of their children!

 


What are your experiences working on a birthing team?

Jerri shares some of her experiences, both positive and negative, working with others on the birthing team. (5:04)

English Summary

Jerri answers that she’s had both positive and negative experiences. In one situation, a nurse was not very open to having her there. At one point, Jerri was supporting the mom’s wish to get out of bed and move around in opposition to the nurse’s orders to stay in bed. As far as Jerri could see, there was no medical reason for the mom to stay in bed and she felt it was part of her job as a doula to support the mom’s instincts about what was best for her labor process. The staff was not happy about Jerri’s perceived interference and after that tried to send her out of the room for errands. Jerri had to stand her ground and continue to emphasize that she was there to support the mom, not the staff, and would need to stay in the room to do so. Although it wasn’t a good experience, she thinks she handled it well.

A more positive experience happened when the doctor, nurse and even the midwife were supportive of having a doula present. They encouraged Jerri to support and comfort the mom and even offered suggestions and techniques for Jerri to use. The result of the cooperation by the team was that the mom felt wonderful and very proud of herself and her new baby.

After working with that particular team, they called on her services any time she happened to be in the hospital and they had a woman in labor. Although she did not have a previous relationship with the mom, she was able to offer her support. Some women were very grateful to have her with them. Overall, the team approach has lead to great outcomes for the moms.

Jerri re?ects on how fathers have worked with her in the past. She notes that they often do not fully understand the birth process and can actually interfere with it. It is a ?ne line for her trying to decide whether to step in or not. In one case, the mother was wanting a natural childbirth, while the doctor wanted something else. The husband preferred to follow the doctor’s wishes and was criticizing his wife for wanting to stay with her plan. (This was the woman’s second baby, the man’s ?rst) Finally, Jerri felt compelled to step in and tell the husband that his criticism was not helpful to the mom and he needed to offer support instead and save the criticism for after it was over. Unfortunately, the husband was not particularly swayed and still felt that the mom needed to comply with the doctor’s desires. At one point the father left the room, offering Jerri the chance to talk with the mom and ask how she wanted to handle things. The mom asked Jerri to do what she could to keep the father out of the room, which they managed to do and the mom proceeded to deliver naturally with the father almost missing the birth itself. It was a sticky situation trying to support the mom and not overstep boundaries with the father.

But every situation is different.

 


Are there differences between working with first-time and experienced moms?

Jerri explains the differences in working with women going through their first pregnancy and those who have previously given birth. (2:48)

English Summary

Jerri compares a woman who was a first time mom and a woman who was giving birth to her fifth child. The first time mom really had no idea what was going on with labor and birth. She did not understand labor pains, and was frustrated and thought she must be doing something wrong for it to hurt so much. She wanted a natural childbirth, but didn’t fully understand what that meant. Jerri had to spend a lot of time explaining that what the mom was experiencing was normal in a natural childbirth.

In contrast, working with a mother who has experience is much easier because the mom is ready and knows what to expect. Jerri doesn’t have to go to the hospital until right before the baby is born. Jerri is still needed in those situations in part because Deaf moms sometimes have bad experiences in medical settings because of the medical staff and their medical perspective about Deaf people. Jerri sometimes feels she has to defend the mom from comments about whether or not she should even be pregnant, from being thought of as Deaf and dumb and ignorant or being patronized by the staff. So even moms with birth experience need Jerri’s support to run interference with the medical staff. Not that she is harsh with them, she knows it wouldn’t help to order them all out of the room. Instead she tries to either speak to what the mom wants or to encourage the mom to speak up for herself and just encourage dialogue. It doesn’t always work, sometimes the mother’s wishes get overridden in favor of what the medical staff says, but that can’t be helped.

So that’s a comparison of working with a ?rst time vs. an experienced mom.

 


What are your experiences working with interpreters?

Jerri shares some of her experiences working with interpreters in birthing situations. (4:11)

English Summary

Jerri re?ects on positive and negative experiences working with interpreters. She remembers a good experience where the interpreter stayed very neutral and did not get too involved with the birth process. She was able to maintain a professional boundary because Jerri was there, which relieved the interpreter of her feeling tempted to give help and support to the mom. Jerri shares that she does not expect there to be an interpreter provided for her, even though she is hard of hearing. But when the mom is Deaf, she knows she can expect an interpreter to be present, but she does not require one and can actually make do without one anyway.

The interpreter she admired knew where to place herself in the room, discreetly kept Jerri informed of things she needed to know, such as what she could hear the medical staff saying behind a privacy curtain. In some cases it helped prepare Jerri and the mom prepare for what the medical staff might suggest, particularly if it was not what the mom had planned for her birth. So an interpreter can be very helpful for things like that.

By contrast, Jerri recounts an experience where the interpreter got too involved in the process. In this case, the mother was a Deaf adult who was “low functioning” (although Jerri doesn’t like the prejudicial tone of that label). The mom did not have a good understanding of what was happening during labor and it made the process more difficult to manage. She was vulnerable to manipulation by anyone in the birthing room and Jerri felt her role was, in part, to protect the mother’s birthing environment. People kept coming into the room and giving directives to the mom and to Jerri, including the interpreter! Jerri was really taken aback, wondering if the interpreter would feel it was her job to tell the doctor what to do instead of interpreting. So many people were in the room and becoming involved (including the interpreter) that the mother became overwhelmed and eventually Jerri felt she had no option but just to back off and give up her efforts to support the mother. She felt that clearly the interpreter had not kept a professional boundary and went way beyond her role, which was to interpret what people said and that’s all.

That was a bad experience, but most of the time she ?nds interpreters very professional and has good experiences working with them.

So that’s a comparison of working with a ?rst time vs. an experienced mom.

 


Do you have any final thoughts to share?

Jerri shares some final thoughts about doulas. (2:48)

English Summary

Jerri says how much she would like to see other Deaf women and interpreters become doulas. Deaf women in her research study said they wished interpreters could also be trained as birth coaches so Deaf moms would have direct support. She hopes to become a trainer to help more Deaf women and interpreters become doulas. She thinks it would be very helpful to have someone there who shares the same language to support the mom and keep her informed about what’s going on around her during labor and delivery.

She has a friend who is a doula and interpreter but she does not like trying to maintain both roles. If she is providing encouragement and possibly physically supporting the pregnant woman and then the doctor or nurse comes in, she has to actually step away from the mom to interpret and that does not feel comfortable.

Jerri thinks other people may feel differently and that it’s up to each person to know what they’re comfortable with. She would like to see more discussion with interpreters who have also done birth support to see if those issues of role con?ict are a problem for them. It’s an area that needs further study.

 

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